Ex­tra meal can save el­derly pa­tients

HAV­ING one more meal a day could halve an el­derly pa­tient’s risk of dy­ing in hos­pi­tal, an NHS pi­lot scheme has shown.

Nutri­tional ad­vis­ers at five trusts in Eng­land and one in Scot­land made a fourth meal for hip frac­ture pa­tients and sat with them while they ate.

Mor­tal­ity among the pa­tients fell from 11 to 5.5 per cent and the av­er­age length of stay in hos­pi­tal dropped from 25 to 20 days.

About 4,000 el­derly peo­ple die each year within a month of be­ing ad­mit­ted for a hip frac­ture. Ex­perts said older pa­tients of­ten fail to eat enough nu­tri­ents while bed­bound. Mr Do­minic In­man, chief or­thopaedic sur­geon for the Na­tional Hip Frac­ture Data­base who helped set up the scheme, said: “The fo­cus of our look at nu­tri­tion was to try to im­prove the help pa­tients would get with eat­ing both main meals but also hav­ing snacks in be­tween to try to build up their calorific in­take dur­ing their hos­pi­tal stay.

“At that point it’s all about get­ting calo­ries into the pa­tient. If you look upon food as a very, very cheap drug, that’s ex­tremely pow­er­ful.” Vis­it­ing fam­ily and friends were also en­cour­aged to bring snacks for pa­tients.

Doc­tors said the ex­tra calo­ries, plus a mo­rale boost from hav­ing com­pany at meal­times, made a huge dif­fer­ence to death rates.

Trauma

Northum­bria Health­care NHS Foun­da­tion Trust, which pi­o­neered the scheme in 2016, said it could save about £1,437 a pa­tient a year.

Pro­fes­sor Mike Reed, a con­sul­tant trauma and or­thopaedic sur­geon at the trust, said: “A hip is a very bad break to have. Many pa­tients are al­ready frail and el­derly, then the trauma of the fall and the de­mands can be very dan­ger­ous. It’s clear that the ex­tra food is help­ing these pa­tients dra­mat­i­cally.”

Prof Reed said the trust is work­ing with The Health Foun­da­tion char­ity to get the scheme rolled out across the coun­try.

He added: “We’ve spent around £20,000 a year per hos­pi­tal. It’s a very cheap in­ter­ven­tion. In Northum­ber­land we have rolled this out across the vast ma­jor­ity of wards. Fo­cus­ing on nu­tri­tion could make a dif­fer­ence to all sorts of pa­tients, not just hip pa­tients.”